Clinical Characteristics and Etiology of Epilepsy in Children Aged Below Two Years: Perspective From a Tertiary Childcare Hospital in South Punjab, Pakistan

Abstract

Background Epilepsy is described as an enduring disposition toward recurrent unprovoked seizures and by the neurobiological, cognitive, psychological, and social consequences of this condition. This study aimed to find the clinical characteristics and etiology of epilepsy in children aged below two years. Methodology This cross-sectional study was conducted at the department of pediatric neurology, the Children's Hospital and Institute of Child Health, Multan, Pakistan, from February 2021 to July 2021. During the study period, a total of 226 children of both genders, aged below two years, presenting with epilepsy and who underwent electroencephalography (EEG) were included. Socio-demographic and clinical data along with clinical features and radiological/imaging findings were noted. Results In a total of 226 children, 121 (53.5%) were male and 105 (46.5%) female. Overall, the mean age was calculated to be 14.6±5.2 months while 107 (47.3%) children were aged between 13 to 24 months. Residential status was found to be rural in 142 (62.8%) children. Generalized seizures (both primary and secondary) were reported in 205 (90.7%) children while the remaining 21 (9.3%) children had focal seizures. The most common etiology of epilepsy was noted to be structural/metabolic in 122 (54.0%) children. Abnormal EEG findings were observed among 150 (66.4%) children. Developmental delay (p=0.0016), hypotonia (p<0.0001), microcephaly or macrocephaly (p<0.0001), abnormal brain CT or MRI (p<0.0001), and abnormal EEG findings (p=0.0161) were found to have a significant association with etiology of epilepsy. Conclusion Generalized seizures like tonic-clonic and clonic types were the most common findings among children below two years of age with epilepsy. Structural abnormalities were the most common etiology in children with epilepsy. Age between one to two years was the commonest age of onset of seizures among young children.

Keywords: developmental delay; electroencephalography; epilepsy; hypotonia; microcephaly.